Male Infertility

Uropartners' Infertility Specialists

Male infertility is a common reproductive problem affecting men. It is a condition where the male in the relationship affects the ability of the woman to become pregnant. When couples are not able to conceive even after having unprotected sex over a long period of time, it is important for both partners to be checked by their physician.

With the advancements in medical technology, it is now possible to treat the condition of male infertility. At Uropartners, our doctors work with you to develop an individualized treatment plan that helps you move toward your goal of conception. Our experts use the latest techniques to diagnose the cause and rule out other underlying conditions that can lead to infertility.

With Specialists at Uropartners, becoming a parent is no longer a distant dream. All your infertility issues will be handled with in the most professional manner so that you get positive results. We help you achieve your goals and fulfill your hopes and dreams of having a complete family.

Am I a Candidate

Male infertility factors are indentified in 50% of couples with difficulty conceiving. Male infertility is a common reproductive problem affecting men. It is a condition where the male in the relationship affects the ability of the woman to become pregnant. When couples are not able to conceive even after having unprotected sex over a long period of time, it is important for both partners to be checked by their physician. Various factors, such as anxiety, depression, aging, hormonal imbalance, consumption of excessive alcohol, smoking, certain medication and underlying disease conditions may affect the reproduction of men.

If you have been unable to conceive after a year of unprotected sexual intercourse, talk with your doctor about fertility evaluations.

At Uropartners, we offer a full range of diagnosis and treatment.

Cause of Male Infertility:

Male fertility may be impaired by a number of factors. These include:

Sperm production problems: The quality and quantity of sperm are the key factors to male fertility. Any defect such as immature sperm or low sperm count (oligospermia) can lead to infertility.

Varicoceles: This is a condition characterized by swelling of the veins that supply the testicle.

Backward ejaculation of the sperm

Blockage of the sperm carrying ducts

Development of sperm antibodies (auto-immune disorder)

Hormonal/stress problems

Infections/tumors of the male reproductive system

Genetics (chromosomal disorders)

Sexual problems

Use of certain medications such as steroids

Excessive radiation exposure affects the sperm production.

Work related causes (example: laptop use elevates the temperature of the testes leading to low sperm production)

Smoking and alcohol abuse

Diagnosis:

Your doctor will make the diagnosis of male infertility based on the following:

Medical history

Complete physical examination

Semen analysis: This is a laboratory test carried out to assess the sperm count and quality. The test sample is obtained by ejaculating into a sterile bottle.

Transrectal ultrasound of the prostate: It is an investigation carried out to evaluate the prostate gland and detect any obstruction of the ducts that transport the sperm.

Scrotal ultrasound: This is an imaging test to diagnose abnormalities of the scrotum or testicles.

Testicular biopsy: A small piece of tissue is removed from the testicle using a sterile needle and sent for evaluation under a microscope to help determine the cause of infertility.

Anti-sperm antibody tests to trace the antibodies that attack sperm.

Treatment:

Male Infertility Chicago | Common Reproductive Problem | Chicago, IL

Surgery: Surgery is indicated in cases of varicocele and obstruction of the sperm duct to improve the sperm motion.

Medications: Antibiotics are prescribed to treat infections of the reproductive system.

Treatment for sexual problems: Counseling about sex and relationships can help boost fertility levels.

Male hormone replacement therapy may be used to treat hormonal deficiency.

Assisted reproductive technology (ART): These are revolutionary treatment procedures that help couples with infertility problems to conceive. Some of them include in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) methods.

Lifestyle modification: These include changing habits such as not smoking, limiting alcohol intake, and using stress reduction techniques.

Vasectomy Reversal

A vasectomy is a surgical procedure performed in men as a means of permanent birth control to prevent reproduction. Vasectomy reversal is a surgical procedure where the ends of the sperm carrying tubes, the vas deferens that were cut and sealed during vasectomy are joined back together to enable reproduction.

Procedure:

Vasectomy reversal is a sophisticated procedure which can be attempted by two different surgical approaches:

Vasovasostomy: In this procedure, the cut ends of the vas deferens (the sperm carrying tubes) are reconnected by the surgeon.

Vasoepididymostomy: This approach involves the connection of the detached vas deferens to the epididymis (a tube that lies at the back of each testicle and stores sperm).

The surgeon makes the decision whether to employ either of the approaches or a combination based on the fluid sample taken at the start of the procedure.

Vasectomy reversal is generally carried out as a day procedure under general anesthesia. The surgeon makes a small incision in the skin of the scrotum, the sac that contains the testes. The surrounding structures are retracted to expose the testicle. The vas deferens is carefully cut and inspected for fluid. This fluid will then be examined for the presence of sperm. When the surgeon confirms the presence of sperm with motility, the tubes are reconnected to enable the transit of sperm.

In cases where there is no seminal fluid or fluid is present but has no sperm, a Vasoepididymostomy would be performed in a similar manner except the detached vas deferens would be connected to the epididymis.

Post-operative care:

Following are the post-surgical guidelines to be followed after surgery:

Apply ice packs over the scrotum to reduce the post-operative swelling.

Your doctor may prescribe medications to help alleviate pain and make you feel comfortable.

Wearing an athletic supporter at all times for the first four weeks help support the testicles and reduce swelling and movements.

Keep the surgical area clean and dry.

Recreational activities such as sports and lifting heavy weights are restricted for a few weeks.

Return to work depends on how well you are healing and the type of work or activity level you perform.

Sexual activity can be resumed after about six weeks following surgery.

Risks and complications:

The potential risks and complications of vasectomy reversal include:

Infection

Excessive blood loss

Chronic pain

Nerve injury

Hydrocele, an abnormal collection of fluid in the scrotum

Varicocele Treatment

Varicocele is a condition of abnormal enlargements of the veins in the spermatic cord that carry the blood from testes to heart. They mostly occur during puberty and are more common in men between 15 and 25 years. Varicoceles happen more often on the left testicle, sometimes they occur on both sides.

Blood flow in these veins is regulated by group of valves that ensure one-way blood flow, from testes to heart. Any abnormality or impairment in these valves may cause backward flow of blood and pooling of blood in veins. This may cause swelling and widening of veins and the condition is called as varicocele. Varicocele is similar to varicose veins, which are common in the legs. In some cases, it might damage the testicle or decrease the sperm production, leading to infertility in men.

In most cases, men diagnosed with a varicocele have no symptoms and in other cases individuals may present with symptoms such as dull ache and discomfort in the testicle, enlarged twisted veins in the scrotum and feeling of heaviness in the scrotum. The symptoms may worsen with physical exertion, hot weather, sitting or standing for a long time.

Varicocele may be diagnosed during routine examination. The groin area (area where the upper thigh meets the trunk), including the scrotum and testicles are examined. Non-tender twisted mass along the spermatic cord is felt and have been described as having a “bag of worms” because of the appearance and the way they are felt.Varicocele is generally harmless and often requires no treatment. Anti-inflammatory medications are prescribed, if varicocele is associated with pain and swelling. Wearing snug underwear or a jock strap may offer relief from pain and discomfort. However persisting or severe pain necessitates medical intervention.

Varicocelectomy is a surgical procedure to correct a varicocele. The procedure is performed under anesthesia by an urologist. An incision or cut is made usually in the lower abdomen, and the affected abnormal veins are tied off, to redirect the flow of blood into other normal veins. Ice packs should be kept on the area for the first 24 hours after surgery to reduce swelling.

An alternative to surgery is percutaneous embolization. It is a minimally invasive treatment for varicocele which is performed under anesthesia. A catheter, small hollow tube, is placed or inserted into a vein in the groin or neck area. After radiographic visualization, the tube is moved into the varicocele, and a tiny coil is passed through the tube. The coil blocks the blood flow to the abnormal vein, and sends it to normal veins and rectifies the abnormal blood flow. Ice packs are applied to bring down the swelling.

Risks and Complications

Complications following varicocele repair include infection, hematoma (blood clot formation), injury to the scrotal tissue or structures, injury to the artery that supplies the testicle and recurrence of varicoceles.

Azoospermia – No Sperm Count

Azoospermia is a condition that involves absence of sperm in the seminal fluid. The condition causes infertility in males and requires male infertility treatments for those who wish to reproduce with their partner. The most common cause of azoospermia is associated with either sperm production or any obstruction in sperm delivery. In many cases, men with azoospermia do not show any symptoms or indications, unless their partner experiences difficulty in getting pregnant.

Causes

The causes of azoospermia can be of two types: non-obstructive azoospermia and obstructive azoospermia.The non-obstructive azoospermia occurs due to abnormal sperm production. The major causes of this condition include hormonal problems, testicular failure, and varicocele. Improper functioning of the pituitary hormone can also severely reduce or stop sperm production. Testicles are the part of the male genitalia that produce an adequate number of mature sperm. Any impairment in the testicles due to genetic abnormalities or other reasons also hampers mature sperm production. Sometimes a condition called a varicocele, dilation of the veins of the scrotum, may also disrupt sperm production. Dilation of the veins causes pooling of extra blood to the scrotum and has a negative impact on sperm production.Obstructive azoospermia is the result of obstruction or blockage in the sperm-carrying duct called vas deferens. This prevents sperm from being delivered into the ejaculate. The obstruction of the duct may be a result of prior surgery involving the scrotum, testicle or an inguinal hernia, or history of infections such as gonorrhea. Sometimes, a genetic abnormality such as absence of the duct from birth is the cause of azoospermia.

Diagnosis

The diagnosis of azoospermia includes a complete medical history, physical examination, tests of selected hormones and male fertility tests include sperm analysis. The medical history and physical examination of the patient evaluates any childhood illnesses or disorders or any family history of reproductive problems, presence of dilated veins or varicoceles and secondary sex characteristics. Hormonal testing includes measurements of testosterone and follicle-stimulating hormone (FSH) in the blood serum to evaluate for any hormonal imbalance. Other tests such as transrectal ultrasound, urinalysis, or testicular biopsy can also be used to diagnosis the condition.

Treatment

Treatment of the azoospermia depends on the cause of the condition. In obstructive azoospermia, the blockage can be corrected through a surgery. Treatment of non-obstructive azoospermia represents a greater challenge. Sometime hormonal medications can be prescribed to regulate the sperm producing hormones. Otherwise fathering a child can be achieved through microsurgical testicular sperm extraction (TESE) procedure. TESE procedure involves removal of testicular tissue for the extraction of sperm to fertilize an egg to be used for in vitro fertilization. Following a proper diet, healthy lifestyle and regular exercising also can be helpful to improve male fertility.